INTRODUCTION

The therapeutic relationship is the heart of therapeutic practice. Decades of research indicate that the provision of therapy is an interpersonal process in which the main curative component is the nature of the therapeutic relationship.

In this program, we look at many aspects of the constantly evolving therapeutic relationship, taking into account important new knowledge gained from neuroscience, infant research, theory about attachment, and the seismic changes in our culture which affect all aspects of our world view.

Probably the most significant change in the treatment process has come with the opening up of the therapeutic relationship. Once a stiff, one-person, "blank screen" model, where the therapist was the all-knowing, powerful "expert", now psychotherapy is viewed by virtually all the varieties of "talk therapy" as a collaborative process.


CURRICULUM SUMMARIES

Interview #1:  Scott Miller, Ph.D. "Super Shrinks"

To begin our program, we will take a look at what makes one therapist "better" than another. And yes, some therapists are better, as indicated by their higher scores on all sorts of performance measures. In our first interview, Dr. Scott MIller shows us that we can, and must measure and evaluate our work.

Interview #2:  Arthur Nielsen, MD "The First Session, as Seen in 'In Treatment'"

The true core of all psychotherapy is always the intimate relationship that forms between therapist and patient, containing emotion and drama. The first session in any therapy present a unique opportunity which has been recognized by experts for decades, even being referred to as having "a sacred nature." Everything the therapist says and does in this first session conveys his or her concern, competence, and interest in helping the patient and evokes intense feelings in both patient and therapist. Dr. Arthur Nielsen discusses both the HBO program, "In Treatment", and first sessions.


Interview #3:  David Wallin, Ph.D. "Attachment-Oriented Psychotherapy"

Perhaps the most significant development in contemporary psychoanalytic thought has been attachment theory. In this interview, Dr. David Wallin translates attachment theory and research into a framework that integrates key attachment principles with psychopathology, with neuroscience, with relational and intersubjective psychotherapeutic approaches, with mentalization, and with mindfulness.

Interview #4:  Judith Rustin, LCSW "Self Psychology and Neuroscience"

Infant research and neuroscience add additional ways to understand and interact with patients in the clinical encounter, and offer specificity and nuance to basic self-psychological concepts. Findings from infant research delineate the nature of attunement both in early mother-infant and therapist-patient interactions, while neuroscientific research reveals how early mother-infant experiences are encoded in implicit memory and profoundly impact affects and feelings. To Judith Rustin, LCSW, the concept of “implicit memory,” defined as unspoken aspects of communication and interaction formed in infancy and early childhood, is a major contributor to therapeutic action, a powerful tool enabling the therapist to “know” the patient more fully.

Interview #5:  Pamela Hays, Ph.D. "Cultural Complexities"

Diverse cultural influences have required contemporary therapists to modify their world views. To work effectively with people of diverse identities, we must learn to deal with difference and conflict in ways that do not simply reinforce dominant power structures, but rather, empower and show respect for one another.  Dr. Pamela Hays presents a paradigm for identifying one's own biases.

Interview #6:  Judith Nelson, Ph.D. "Crying in Psychotherapy"

The default reason for crying is separation. The same biological, psychobiological behavior that occurs in infants to bring about reunion with the caregiver also occurs at the death of a close loved one, and Judith Nelson, Ph.D. has translated this into an understanding of crying in psychotherapy.

Interview #7:  Frank Summers, Ph.D. "Psychotherapy and the Economy, Part 1"

Frank Summers, Ph.D. shares his observations on the impact of the economy on his practice and discusses the dilemmas this situation raises, explaining the factors involved in modifying one's stance on fees.

Interview #8:  Karla Clark, Ph.D. "Psychotherapy and the Economy, Part 2"

Karla Clark, Ph.D, discusses the dilemmas involved in making a decision to reduce a patient's fee, stresses why the therapeutic frame can be vital to keeping one's clarity and perspective on this subject, and why the therapeutic relationship cannot be a sale item!

Interview #9:  Richard Geist, Ed.D. "Self Disclosure--a New Paradigm"

Dr. Richard Geist is interested in the clinical possibilities that the concept of connectedness offers. Therapists can use the concept of connection as a central organizing principle in the way we listen, interpret, make interventions, and experience our patients. Connectedness is bi-directional. With bi-directionality, not only does the therapist experience and have empathy for the patient; the patient also experiences and has an empathic understanding of the therapist. This has opened up the subject of self disclosure. In this new paradigm, it is often the therapist’s "deliberate" self disclosure that enhances our therapeutic effectiveness.

Interview #10:  Denise Davis, Ph.D. "Termination"

As a result of her research, Dr. Denise Davis, has been able to identify five types of terminations, and in this interview, she discusses how clinicians can end therapy responsibly, even when conditions are challenging. She discusses how to handle pitfalls in the process, and presents a number of essential steps for negotiating a clinically and ethically sound termination.


LEARNING OBJECTIVES

- Learn what differentiates outstanding “super shrinks” from average therapists and how to improve one’s performance.
- Learn about the most fundamental thing to accomplish in the first session
- Understand the classifications of attachment styles in infants and their adult correlates
- Explore how psychopathology develops as a result of attachment issues
- Understand how intersubjectivity and attachment theory and neuroscience fit together to repair derailed development
- Identify three kinds of crying
- Learn a paradigm for recognizing cultural biases
- Recognize the importance of managing the therapeutic frame
- Recognize the factors to consider in deciding to reduce the fee or cut back the frequency of sessions, including one’s countertransference issues on this subject.
- Gain an understanding of a new paradigm for self disclosure and why it is curative
- Identify five types of terminations
- Learn about six steps for negotiating a clinically and ethically sound termination